Family planning practice and predictors of risk of inconsistent condom use among HIV-positive women on anti-retroviral therapy in Cambodia
1 Graduate School of Nursing, Osaka Prefecture University 3-7-30, 583-8555 Habikino-city, Osaka, Japan
2 National Maternal and Child Health Center, 31A, Rue de France Street, Phnom Penh, Cambodia
3 Bureau of International Medical Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, 162-8655 Shinjuku-ku, Tokyo, Japan
4 Graduate School of Nursing, Osaka City University, 1-5-17 Asahimachi, 545-8585 Abeno-ku, Osaka, Japan
5 Graduate School of Nursing, Nagoya City University, Kawasumi 1, Mizuho-ku, 467-8601 Nagoya-shi, Aichi, Japan
BMC Public Health 2014, 14:170 doi:10.1186/1471-2458-14-170Published: 17 February 2014
In Cambodia, while anti-retroviral therapy (ART) services are increasingly available, the unmet needs of family planning among general population are high. These facts raise concern on possible exposure of many HIV-positive women on ART to the potential risk of unintended pregnancy. This study aimed to clarify family planning practices in Cambodia and determine predictors of risk of inconsistent condom use among women on ART.
A cross-sectional survey with a structured questionnaire was conducted at five government-run health centers in Phnom Penh, Cambodia, from June to September, 2012. Multiple logistic regression analysis was used to identify predictors of risk of inconsistent condom use among regular users of contraceptive methods.
Of 408 respondents, 40, 17 and 10 used the pill, IUD, and injection, respectively, while 193 used condoms. 374 were not planning to have a child. Among 238 sexually active women who were not planning to have a baby, 59 were exposed to the risk of unintended pregnancy. Multivariate logistic regression analysis that did not include variables related to partners identified "seeking family planning information" (adjusted odds ratio (AOR): 2.6, 95% confidence intervals (95% CI): 1.1-6.2), awareness of mother-to-child transmission (MTCT) (AOR: 4.7, 95% CI: 1.9-11.6) and "having a son" (AOR: 2.0, 95% CI: 1.1-3.9) were significant predictors of inconsistent condom use. Another model that included all variables identified “able to ask a partner to use condom at every sexual intercourse” was the only predictor (AOR: 23.7, 95% CI: 5.8-97.6).
About one-quarter of women on ART are at risk to unintended pregnancy although most do not plan to get pregnant. Furthermore, women on ART could be more empowered through improvement of communication and negotiation skills with partners to demand the use of condom during sexual intercourse. The use of other contraceptive methods that do not need partner involvement should be promoted.